By Bryan "Bree" Fram
On June 30th, 2016 the Pentagon lifted the barrier that denied thousands of transgender service men and women the opportunity to serve openly. Since then, they’ve proudly served with distinction and grace. They’ve utilized the opportunities equitably granted to every other service member, such as medically necessary care, to position themselves as even stronger defenders of the nation.
Today, transgender service members will lace up their boots and go to work in service to this nation just as they have done for their entire career. However, those same service members are faced with a reversal of policy that removes their opportunity to better themselves and tells them to leave the military or, if in a narrow segment, stay as a second class citizen. The new version of the ban attempts to be legally palatable, for the same reasons that the courts saw several versions of the travel ban, due to ongoing action against the government in four court cases. Still, the rationale behind the ban fails to accurately reflect the risks and opportunities inherent in service by transgender Americans.
As one of the nine transgender service members who had the opportunity to discuss our experiences with the Panel of Experts in the Department of Defense, I believe these are some of the key areas where the rationale for this new ban is worth scrutinizing.
Medical Utilization Rate
Claiming that medical costs are unreasonable, the report presents that “Service members with gender dysphoria are also nine times more likely to have mental health encounters than the Service member population as a whole” and that units had to fund “extensive travel… to obtain specialized medical care.” However, the report fails to note these costs and required medical visits are driven by the service’s own policies regarding gender dysphoria care. For example, the Air Force sends all Airmen diagnosed with gender dysphoria to a week-long medical evaluation in San Antonio that could be accomplished at most member’s duty stations or could be worked via telemedicine. The other services require no such travel expense and the majority of care is provided locally.
The report expresses concern that “the stresses of military life… will be additional contributors to suicide behavior in people with gender dysphoria” yet presents data that shows the consideration of suicide of transgender military members as almost 5 times lower than that of non-military transgender people without a supportive family. The military, as an accepting institution with medical care, becomes a major protective factor against the external pressures that lead some transgender individuals to consider suicide. As far as I am aware, there have been no known suicides of active duty transgender service members since the policy change.
The report claims that “…most persons requiring transition-related treatment could be non-deployable for a potentially significant amount of time.” Yet, the report includes evidence of how that can easily be worked around. It fails to account for non-transgender individuals that take the same medications or having some of the same surgeries, such as a hysterectomy, and continue to serve and deploy without restriction. Hormone replacement therapy is not exclusive to gender dysphoria and is not considered restrictive.
There are no gender dysphoria treatment plans that have the service member non-deployable for 12 or more consecutive months which meets the standard for all service members laid out by DoD. One service members who shared her story with the panel laid out how she was able to complete her transition without any effect on her deployability as a member of the infantry. She coordinated necessary care during personal leave and training time where only light duty was required.
The report referenced one commander that had a service member opt to delay surgery in order to deploy. The number is small because the panel talked to so few people. I know of many, many others who have done the same. Transgender service members put the mission first just like the non-trans service member who delays a medically necessary yet non-emergency procedure, such as shoulder repair, in order to deploy with their unit.
The report concludes that “Although military leadership from the prior administration reached a different conclusion, the Department's professional military judgment is that the risks associated with maintaining the Carter policy counsel in favor of the recommended approach.” Yet, due to the timeframe between the two decisions many of the same military leaders are still in place. Did their thoughts change so radically? It is only the Department’s judgement which has changed. The facts, aside from almost two years of honorable service from transgender service members, have not.
To transgender service members, this new policy serves only to distract us from our mission to fight and win our nation's wars. We must tune it out and continue to serve with integrity as the lethal and ready force we are until either the ongoing court cases are resolved in our favor, a legislative solution is reached, or we take off the uniform for the last time. I'm confident our nation will reach a point where our service and sacrifice is valued in the same way as every other American willing to fight and die for our highest ideals.
Bryan Bree Fram is the Policy Chair of SPARTA and an active duty Air Force Lieutenant Colonel. The views expressed here are personal and do not reflect those of the Air Force or the Department of Defense